Factors associated with health facility delivery among reproductive age women in Nepal: an analysis of Nepal multiple indicator cluster survey 2019

Abstract

Abstract Background Despite existing efforts to improve maternal health in Nepal, delivery in a health facility with skilled providers is still a major health concern in Nepal. This study aimed to examine the factors associated with delivery in a health facility with skilled providers among women aged 15–49 years in Nepal. Methods This study used data from Nepal Multiple Indicator Cluster Survey 2019, a nationally representative cross-sectional survey. This survey was a two-stage, stratified cluster sampling. A total of 1,950 married women aged 15–49 years who had at least one live birth in the last two years preceding the survey were included in the analysis. Bivariate and multivariate logistic regression analyses were performed in this study. Results Seventy-five percent of women are delivered in a health facility with skilled providers. Women from urban areas (AOR = 1.74, p < 0.01), women residing in Sudurpaschim province (AOR = 5.64, p < 0.001), women with first parity (AOR = 2.82, p < 0.001), and women from rich household status (AOR = 4.60, p < 0.001) and women who attained at least four ANC visits (AOR = 10.81, p < 0.001) were associated with higher odds of delivering in a health facility. Women who were more educated and used the internet were more likely to deliver in a health facility by a skilled provider. Conclusion Place of residence, household wealth status, and ANC visits appear to be the strongest predictors of health facility delivery with skilled providers in Nepal. Disparities in delivery in a health facility with skilled providers persist among provinces and caste/ethnicity.

Keywords

• Antenatal care
• Home delivery
• Health facility delivery
• Maternal mortality
• Multivariate analysis